LAUSR

Aims The Syrian refugee crisis is entering its 7th year. There are various humanitarian organisation are on the ground conducting short-term medical missions. We aim to describe the clinical care that was delivered and my personal reflection on a short-term medical mission to Jordan with the Syrian American Medical Society (SAMS). Methods Through the 6 day mission, we held 6 paediatric clinics each in various locations across Jordan including the Al-Zataari refugee camp near the Syrian border. We gathered prospective quantitative data including age, presenting complaint, diagnosis, management and prescription. The qualitative data is my own personal reflection on the mission. Results We saw a total of 384 patients with an average of 32 patients per day. The average consultation time is 10 min per patient. The most common presenting complaint is sore throat with or without fever (41%). 30% of presenting complaint is related to poor growth or lack of appetite. The most common primary diagnosis is viral upper respiratory tract infection (60%). Significant diagnosis include secondary nocturnal enuresis (10 patients), rickets (1 patient), severe pneumonia and dehydration (1 patient), untreated cleft lip and palate (1 patient). Almost 75% received prescription for paracetamol. Amoxicillin was dispensed to 21% of patients. The unwell patient with pneumonia and dehydration was stabilised locally then sent to the referral hospital. The outcome of her progress is unknown. The patient with untreated cleft was referred via SAMS to a charity specialising in cleft repair. She received her operation a week after the mission. Conclusion The high rate of well children with acute respiratory disease is attributable to living conditions and desert environment. Rigid dispensing of amoxicillin is important to prevent unnecessary use of antibiotics especially as they are able to purchase without prescription. Trauma is the most likely cause of nocturnal enuresis and the need for mental health support cannot be underestimated. Assessment of anaemia and vitamin D deficiency is prime to avoid chronic complications. While the mission is rewarding personally, there can be further improvements to create a more sustainable model of care. Trainee participation in such missions should be encouraged to raise awareness of refugees’ plight and for clinical experience.